Case Scenario: Anesthetic Implications of Restless Legs Syndrome

ESTLESS legs syndrome (RLS) is characterized by sensory (urge to move, usually associated with legs paresthesia and dysesthesia) and motor (voluntary and involuntary leg movements) symptoms occurring selectively when the individual is at rest, during the evening and night. This neurologic, dopa-responsive condition is common, especially in middle-aged women, yet poorly recognized. Acute exacerbation of RLS may occur in perioperative settings because it is worsened by immobilization, perioperative use of neuroleptics and antihistamines, withdrawal of dopaminergic agents, sleep deprivation, and blood loss. The patients become agitated, with limb jerks, generalized akathisia and major pain, possibly leading to surgical consequences. The purpose of this Case Scenario is to highlight the anesthetic implications of RLS.